Controversial French Decree for Drug-induced Abortions at Home during COVID-19 Crisis

A new French decree which became effective on April 14, 2020 extends deadlines for having drug-induced abortions at home from 5 to 7 weeks of pregnancy (corresponding to 7-9 weeks amenorrhea) during the Covid-19 health emergency.

Repeatedly questioned by Senator Laurence Rossignol (Oise, Socialist Party) about f6acilitating access to abortion during the confinement period, the French Health Minister, Olivier Véran declared, during the government session on April 1, 2020, that he was concerned about “an alarming drop in the number of abortions”. Nevertheless at that time, he declined to give a precipitous response to modify the legal time limits.

On April 7 the French Health Minister called upon the High Authority for Health (“HAS”) “to rapidly draft recommendations for carrying out drug-induced abortions outside health establishments at 8-9 weeks amenorrhea, to analyze pain treatment in this context which may modify the practices of prescribing anti-inflammatory drugs.” Two days later, on April 9, the recommendations destined for the new decree were issued by the “HAS

Since 2004, drug-induced abortions could legally be carried out at home for up to 5 weeks of pregnancy under certain conditions, and for up to 7 weeks in a hospital. Thereafter and up to the legal deadline of 12 weeks of pregnancy (14 weeks amenorrhea), only surgical procedures can be performed.

The “HAS” justifies its’ new recommendations (referred to “rapid responses”) by stating that “it is imperative to ensure that women continue to have access to their abortion rights during the current epidemic, with conditions that do not lead to extend the legal deadlines, limit the exposure of patients and professionals to COVID-19, and do not jeopardize the resources of health establishments”.

The document points out that these “quick responses” are only applicable because of the emergency caused by the present epidemic crisis. As far as at-home abortions prolonged to 8 weeks of amenorrhea, the “HAS” recommends women to take twice the usual dose of misoprostol, a drug which, until now, has not received marketing authorization for this purpose (off-label prescribing). The woman must be within an hour’s distance of a referent health center in case of complications, especially hemorrhage, (up to 5% risk, according to the HAS 2018 product notice about adverse side-effects). In the event of severe pain, it is recommended to not remain at home alone.

The decree specifies that the compulsory medical consultations can be carried out by video, but there is no mention of how the woman’s written consent for abortion is to be obtained, nor any mention of ensuring listening and support, which is guaranteed by the law. In addition, the drugs prescribed for aborting (mifepristone and misoprostol, taken at intervals of 24 or 48 hours), are to be dispensed by the pharmacy, directly to the woman, whereas previously, these drugs were only dispensed by a doctor or a midwife.

Caroline Roux, Alliance VITA’s Assistant General Delegate declares:

“This grave decree may have significant health and psychological consequences for women. Advocating this type of drug-induced abortion implies that the decision is made in a hurry, and it may also convey a foregone conclusion that it is the best solution. Meanwhile women are left alone, to suffer in solitude during this epidemic. In addition, it is well-known that late term abortions are more risky and need to be monitored more carefully, due to more severe pain at later gestational ages, and due to an increased risk for heavier bleeding and hemorrhaging.

Was it really “essential” to promote “confined abortion” and mobilize our caregivers for this type of emergency procedure? Is this how we show our respect for women? “

The real health emergency is that pregnant women may receive the support and safety they need, and have the necessary assistance if problems arise. It is also essential to shield women from all types of violence, including a violence often initiated by men: the pressure to abort against their will.

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